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Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates.

Abstract

Spanish medical graduates who apply for a medical specialty training position (MIR) must take an examination that will shape their future personal and professional lives. Preparation for the test represents an important stressor that persists for several months. The aim of this study was to elucidate the stress pattern of this group and evaluate possible changes in the circadian rhythm of cortisol release in medical graduates preparing for this test. A repeated-measures longitudinal study was performed, measuring the salivary cortisol concentrations in 36 medical graduates (13 males and 23 females; mean age of 24.2 years) on five sampling days. Five cortisol samples were collected from 07:00 to 21:00 h in order to monitor changes in the circadian rhythm. On all sampling days (except on the day of the official examination), anxiety and psychological stress were evaluated with the Spanish versions of the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS). During the study period, participants showed higher levels of anxiety than the Spanish reference population as well as a progressive increase in self-perceived stress. A significant increase in salivary cortisol concentration was observed in both chronic (study and examination preparation) and acute (examinations) situations. Our results suggest that the cortisol awakening response (CAR) may be a good indicator of anticipatory stress but is unaffected by long-term examination preparation. Comparison of results between the official examination day and the mock examination days yielded evidence that learning may modulate the behavior of the hypothalamic-pituitary-adrenal axis.

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  • Authors+Show Affiliations

    ,

    Faculty of Education, International University of Rioja (UNIR) , Logroño , Spain .

    , ,

    Source

    Stress (Amsterdam, Netherlands) 17:2 2014 Mar pg 149-56

    MeSH

    Adult
    Anticipation, Psychological
    Circadian Rhythm
    Educational Measurement
    Female
    Humans
    Hydrocortisone
    Hypothalamo-Hypophyseal System
    Male
    Medicine
    Performance Anxiety
    Personality Inventory
    Pituitary-Adrenal System
    Saliva
    Severity of Illness Index
    Spain
    Stress, Psychological
    Students, Medical
    Surveys and Questionnaires
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24351081

    Citation

    González-Cabrera, J, et al. "Acute and Chronic Stress Increase Salivary Cortisol: a Study in the Real-life Setting of a National Examination Undertaken By Medical Graduates." Stress (Amsterdam, Netherlands), vol. 17, no. 2, 2014, pp. 149-56.
    González-Cabrera J, Fernández-Prada M, Iribar-Ibabe C, et al. Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates. Stress. 2014;17(2):149-56.
    González-Cabrera, J., Fernández-Prada, M., Iribar-Ibabe, C., & Peinado, J. M. (2014). Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates. Stress (Amsterdam, Netherlands), 17(2), pp. 149-56. doi:10.3109/10253890.2013.876405.
    González-Cabrera J, et al. Acute and Chronic Stress Increase Salivary Cortisol: a Study in the Real-life Setting of a National Examination Undertaken By Medical Graduates. Stress. 2014;17(2):149-56. PubMed PMID: 24351081.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates. AU - González-Cabrera,J, AU - Fernández-Prada,M, AU - Iribar-Ibabe,C, AU - Peinado,J M, Y1 - 2014/01/13/ PY - 2013/12/20/entrez PY - 2013/12/20/pubmed PY - 2014/10/10/medline SP - 149 EP - 56 JF - Stress (Amsterdam, Netherlands) JO - Stress VL - 17 IS - 2 N2 - Spanish medical graduates who apply for a medical specialty training position (MIR) must take an examination that will shape their future personal and professional lives. Preparation for the test represents an important stressor that persists for several months. The aim of this study was to elucidate the stress pattern of this group and evaluate possible changes in the circadian rhythm of cortisol release in medical graduates preparing for this test. A repeated-measures longitudinal study was performed, measuring the salivary cortisol concentrations in 36 medical graduates (13 males and 23 females; mean age of 24.2 years) on five sampling days. Five cortisol samples were collected from 07:00 to 21:00 h in order to monitor changes in the circadian rhythm. On all sampling days (except on the day of the official examination), anxiety and psychological stress were evaluated with the Spanish versions of the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS). During the study period, participants showed higher levels of anxiety than the Spanish reference population as well as a progressive increase in self-perceived stress. A significant increase in salivary cortisol concentration was observed in both chronic (study and examination preparation) and acute (examinations) situations. Our results suggest that the cortisol awakening response (CAR) may be a good indicator of anticipatory stress but is unaffected by long-term examination preparation. Comparison of results between the official examination day and the mock examination days yielded evidence that learning may modulate the behavior of the hypothalamic-pituitary-adrenal axis. SN - 1607-8888 UR - https://www.unboundmedicine.com/medline/citation/24351081/Acute_and_chronic_stress_increase_salivary_cortisol:_a_study_in_the_real_life_setting_of_a_national_examination_undertaken_by_medical_graduates_ L2 - http://www.tandfonline.com/doi/full/10.3109/10253890.2013.876405 DB - PRIME DP - Unbound Medicine ER -